title: Upper lateral cartilage fold-in flap: a combined spreader and/or splay graft effect without cartilage grafts.
abstract: Dorsal hump reduction almost always breaks the internal nasal valve and nasal obstruction is likely to occur postoperatively, unless reconstructed. One hundred eighty patients were operated using both open and closed rhinoplasty approaches. Upper lateral cartilages were meticulously separated from their junction with septum. Following bony and septal cartilaginous hump removal, upper lateral cartilages were folded inward. Either transcartilaginous horizontal mattress/simple sutures or perichondrial sutures were used depending of the desired width of the middle vault and the necessity for a splay-graft effect. In 7 patients unilateral, and in 1 patient bilateral, nasal synechia occurred and they were all treated under local anesthesia. All patients but 9 stated significantly improved nasal breathing. There was no inverted-V deformity or middle-vault narrowing observed. This technique is simple and physiologic, might be applicable for almost all primary rhinoplasty patients. Although it is possible with closed rhinoplasty approaches, it is easier with an open approach.
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery and Hand Surgery, Gazi University Faculty of Medicine, Ankara, Turkey. selozmen@gmail.com
authors.forename: Selahattin
authors.initials: S
authors.lastname: Ozmen
authors.forename: Suhan
authors.initials: S
authors.lastname: Ayhan
authors.forename: Kemal
authors.initials: K
authors.lastname: Findikcioglu
authors.forename: Sebahattin
authors.initials: S
authors.lastname: Kandal
authors.forename: Kenan
authors.initials: K
authors.lastname: Atabay
mesh_terms: D000293:Adolescent; D002356:Cartilage / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000601:surgery*; D012225:Rhinoplasty; D014182:Transplantation, Autologous